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Organization
WELLNESS LOFT INC.
Active
Organization
WELLNESS LOFT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY M GUY MS, LCPC (DIRECTOR)
(217) 347-5118
Entity
Organization
Contact information
Practice address
408 SOUTH 4TH ST., EFFINGHAM, IL 62401
(217) 347-5118
(217) 347-7609
Mailing address
408 S 4TH ST, EFFINGHAM, IL 62401-3703
(217) 347-5118
(217) 347-7609
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.006036
IL
101YP2500X
Professional Counselor
180000748
IL
101YP2500X
Professional Counselor
180002037
IL
1041C0700X
Clinical Social Worker
Primary
149011337
IL
Other
Enumeration date
10/04/2012
Last updated
01/28/2013
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